Back and Neck Pain
504 West 35th St
New York, NY 10001
240 East 59th Street, 2nd Floor
New York, NY 10022
156 William Street, 11th Floor
New York, NY 10038
Back and neck pain comes in many forms. Acute pain heals within a few days or weeks, often on its own. Chronic pain leaves you hurting for at least three months. At Weill Cornell Medicine, our team of pain management specialists brings relief for all types of pain affecting the back or neck to help improve quality of life.
Addressing your condition early often leads to better outcomes and a quicker recovery. The first step toward pain relief is determining the root of your pain.
Myofascial (Muscle) Pain
Back and neck pain is often due to muscle or soft tissue injury. Lumbar (back) or cervical (neck) strain can occur after any event that stresses the neck or back’s soft tissues, including:
● Improper use
● Overuse
● Stress
● Trauma
Treatment Options
Treatment options for myofascial pain connected to back or neck muscles include:
● Medication. You may find relief for minor pains with over-the-counter anti-inflammatory and pain medications. If appropriate, your provider may prescribe prescription medication, such as muscle relaxers or low-dose naltrexone.
● Muscle injections. Your provider injects local anesthetic into painful muscle knots. The anesthetic reduces pain. These are also called trigger point injections.
● Physical therapy. A physical therapist helps you work through movements that bring relief and increase strength and flexibility.
● Transcutaneous electrical nerve stimulation (TENS). Your provider places electrodes on your skin near the affected area. A slight electric current then passes through the electrodes to relieve neck or back pain.
Along with treating common causes of myofascial pain, Weill Cornell Medicine experts treat rare underlying conditions, such as Ehlers-Danlos syndrome. Though there is no cure for Ehlers-Danlos syndrome, proper management reduces symptoms, which may include myofascial pain.
For more information, watch Understanding and Treating Myofascial Pain With Dr. Mariam Ashraf.
Herniated Disc
Injury and the wear and tear of life can cause tears in the outer layer of vertebrae disc. When this happens, the diagnosis is a herniated disc, also known as a slipped or ruptured disc.
As the disc pushes outside of its normal position, it can press against nearby nerves, causing pinched nerves. If it affects a nerve root in the lower back, it can result in sciatica, which causes pain, numbness and discomfort down the leg.
Herniated discs affect men and women of all ages, including children. For some people, they may be genetically predisposed to developing a herniated disc.
Treatment Options for Herniated Disc
If you’re living with a herniated disc, the teams at Och Spine at NewYork-Presbyterian at the Weill Cornell Medicine Center for Comprehensive Spine Care and Och Spine at NewYork-Presbyterian/The Spiral provide a full evaluation and develop individualized treatment plans.
Treatment depends on the location and severity of damage. Fortunately, symptoms often resolve with time and conservative treatment, such as:
● Acupuncture
● Chiropractic care
● Injection steroid therapy (epidural steroid injections)
● Massage therapy
● Muscle relaxants
● Oral steroids
● Over-the-counter pain medications, including anti-inflammatories
● Physical and/or occupational therapy
If conservative treatment is ineffective, your multidisciplinary team considers other approaches. When appropriate, one of our spine surgeons may perform minimally invasive surgery.
Spondylolisthesis
A common cause of back pain in teens, spondylolisthesis is the forward displacement of bone in the vertebral column, leading to misaligned spinal vertebrae. When it affects children or teens, it’s usually due to a birth defect or traumatic injury. In adults, spondylolisthesis typically occurs due to wear and tear, aging or arthritis.
The condition may be:
● Dynamic. The bone moves back and forth with bending.
● Fusion. The bone remains fixed in place.
Isthmic spondylolisthesis is the most common form. It occurs with a slip or fracture of the intervertebral discs. It can lead to facet cysts. These small sacs fill with synovial fluid, which should be lubricating joints, and can cause painful, frustrating symptoms.
Symptoms of Spondylolisthesis
Spondylolisthesis can cause a broad range of symptoms. Early on, you may experience no pain or mild pain. As the condition worsens, lower back pain may worsen.
● Back stiffness
● Buttock pain, numbness or tingling
● Changes in posture and gait
● Hamstring muscle tightness or spasms
● Tenderness around the area of the slipped disc
● Weakness or tingling in the legs and feet
Spondylolisthesis Treatments
As with all back and spine pain, spondylolisthesis treatment typically starts outside the operating room. Nonsurgical treatment options for spondylolisthesis include:
● Electrical stimulation
● Epidural steroid injections
● Lumbar traction
● Lumbosacral orthotic device
● Medications, such as nonsteroidal anti-inflammatory medicines, combined with acetaminophen or corticosteroids
● Physical therapy
● Thermal treatment
When these techniques don’t bring relief, you may undergo surgery for spondylolisthesis. If you’re not a candidate for surgery, neuromodulation may help.
Spinal Stenosis
Spinal stenosis narrows open spaces within the spinal canal, placing pressure on the spinal cord and nerves. Aging is often the cause. However, spinal stenosis can also occur after an injury or due to a related spine condition such as a herniated disc, spondylolisthesis, bone spurs or facet arthritis.
Treatment Options for Spinal Stenosis
Treating spinal stenosis typically starts with exercises. A physical therapist helps you improve flexibility and strength. You may also take anti-inflammatory or neuropathic medications to help relieve pain.
When these approaches don’t bring relief, you may benefit from epidural injections.
If spinal stenosis continues to cause issues, it can be addressed surgically. Options available at Weill Cornell Medicine include:
● Minimally invasive lumbar decompression (MILD). A surgeon removes part of the herniated disc or bone causing the spinal canal to narrow. The procedure takes place through a series of small incisions.
● Interspinous spacers. The surgeon places tiny spacers or a device such as the Vertiflex Superion to help prevent pain and other symptoms of a pinched nerve.
● Intrathecal delivery of medication
Arthritis Pain (Facet Joint)
Neck and back pain can occur due to arthritis and degeneration of bones and joints. This can cause you to experience a variety of symptoms, including stiffness, pain and limited mobility.
Radiofrequency ablation is a minimally invasive method of stopping or reducing pain signals from the body by passing an electrical current to nerve tissue. This nonsurgical procedure has been shown to effectively reduce pain. Learn more about arthritis treatment options available at Weill Cornell Medicine.
Why Choose Weill Cornell Medicine
The Och Spine at NewYork-Presbyterian at the Weill Cornell Medicine Center for Comprehensive Spine Care in New York City consists of a multidisciplinary team of specialists. This team provides personalized, precise care and treatment options for all types of back and neck pain.
Members of your care team may include:
● Pain management specialists
● Psychologists
In addition to advanced services and cutting-edge research, we coordinate care to ensure you receive proper treatment and have a positive experience. Each week, our team meets to discuss challenging cases for additional input and perspectives.
Through our clinical trials, we give you access to treatments that are not available at many health facilities. Learn more about Pain Management's current clinical trials.
Make an Appointment
If you would like to find out more about sciatica treatments for pain management, please contact us today to schedule a consultation.
